I was wondering if anyone could offer me any pointers. I'm a novice, having practiced on my own for two or three years. My focus to date has primarily been on Pure Land traditions, both Japanese and Vajrayana.

I had the good fortune to read the Medicine Buddha sutra and practice the mantra some time ago. Like the sutra suggests, I feel like my mind has been gradually led towards more regular practice of the Medicine Buddha name, which combined with sutra read, brings me great peace.

It would appear as though the Medicine Buddha practice is a complete path to liberation. However, I have some questions over the sutra. Specifically the following lines:

“The merits, virtues and adornments of this realm are identical
to those of Amitabha Buddha’s Pure Land in the west....

"For these reasons, Manjusri, all devout men and women should vow to be born in this land."

And:

“If the patient has a particular wish and single-
mindedly recites this Dharani, his wish will be fulfi lled.
He will be free of disease, enjoy a longer life and, at death,
be born in the realm of the Medicine Buddha. He will then
be beyond retrogression and eventually realize Supreme
Enlightenment."

I know the Medicine Buddha sutra is often part of the Pure Land liturgy. Specifically because of this:

“Moreover, Manjusri, within the Fourfold Assembly of Bhiksus, Bhiksunis, Upasakas and Upasikas, as well as among other men and women of pure faith, there are those who are able to adhere to the Eight Precepts for a full year or for three months a year, dedicating these good roots toward rebirth in the Western Pure Land of Amitabha, the Buddha of Infi nite Life, so as to listen to the correct Dharma.

“If their rebirth in the Pure Land is still uncertain, but they hear the name of the World-Honored Medicine Buddha, then, at the time of death, eight great Bodhisattvas, namely,

will traverse space and descend to show them the way.
They will thereupon be reborn spontaneously in jeweled
fl owers of many hues."

My question is as follows: if the majority, or entirety, of your practice (sutra reading, mantra) is devoted toward the Medicine Buddha, is it still appropriate to dedicate the merits toward rebirth in the Pure Land of Amitabha?

If not, is it appropriate to vow to be reborn in the land of the Medicine Buddha at death, when you have already made a vow to be reborn in the Western Paradise?

I look forward to hearing thoughts from others with perhaps a better understanding than I.

My question is as follows: if the majority, or entirety, of your practice (sutra reading, mantra) is devoted toward the Medicine Buddha, is it still appropriate to dedicate the merits toward rebirth in the Pure Land of Amitabha?

Yes, absolutely. The sutra and that vow explicitly tells you it's okay to do just that.

is it appropriate to vow to be reborn in the land of the Medicine Buddha at death, when you have already made a vow to be reborn in the Western Paradise?

When we become bodhisattvas-mahasattvas, one thing many of us will end up doing is touring through as many pure lands as we can, paying reverence to the Buddhas of those lands, accumulating merit, maybe even playing a role as 'guest teacher' from time to time, as we see the path to completion toward perfect buddhahood. So these rebirth vows are not necessarily mutually exclusive, but it's also important to know that many pure lands -- while still great places in which to learn and practice -- are not empowered by vows like Amitabha's. For instance, Akshobhya's Pure Land doesn't guarantee awakening, just makes it much much much more likely. But even with Amitabha's Pure Land, where we are assured of awakening there, it's also a given that we can leave... and in fact, we must leave, at least once, in order to be reborn in a world system without the dharma and without our memories, to attain awakening on the power of our merit and training, and turn the wheel of dharma.

I also believe that, at a certain point, you can reside in multiple pure lands simultaneously.